Took it today, I guess this is the "new" Step 1. To sum: It was horrible. Wall of text/rant incoming. I'm going to refrain from saying anything specific of course and stick to generalities.
I'd say about 50% of it was roughly, kinda straightforward, as long as you had studied. There were a few give-me's here and there but those were in the minority. Often times, the freebies were preceded by extraordinarily long question stems, so you paid the price of time in exchange for an easy question. There were very, very few buzzwords, but I expected that much going in. Oh, I remember chuckling because they actually used the words "malar rash" for SLE. Yeah, I think that was it. Also, from talking to my dad (who is a physician as well), one of the questions described a disease that apparently has a super classic demographic that I've never heard of in my life. The disease is in FA and I knew it, but this classic demographic isn't in it or any of the review sources, and the actual patient's presentation was pretty different.
A few times every block, I would come across a question where I'd think, "Alright here we go, EZ mode", where I thought I knew almost every detail of the disease from studying Zanki/FA/UWorld/Pathoma/Sketchy obsessively throughout the year. Then I'd find that they wanted me to answer some random aspect of the disease that you wouldn't find in any of the main review sources, or was a tiny detail that was (in one example) literally one word from FA. It's absolutely crushing to come across questions like this; they feel like points slipping right through your fingers.
Then of course there was stuff that no reasonable MS2 would expect to know. I actually thought that people were exaggerating when they said stuff like that; surely we'd be at least roughly familiar with it. Nope. No matter how much you've studied there will be something you would never in a million years get without guessing. Half the time you can't even PoE it because there's still like 6 choices.
Other times they actually deliberately mislead you. Not only did it seem like every question stem was exquisitely long, but many times, the patient had symptoms that clearly included another disease in the differential, and was distinguished by a very small detail. Or they included details in the stem that truly had nothing to do with what they were asking you for, and only served to distract your thoughts. Sometimes there just didn't seem like there really was a good answer at all.
I think the worst part was how much anatomy I had on mine. It was the one topic I was dreading, because our MS1 anatomy course is agreed to be the weakest part of our curriculum at my school. I'd say 4-5 questions per block were anatomy for me; some were easy, some were obscure. I learned all the anatomy from FA and UWorld, and only half of it showed up.
My practice scores were pretty good, and around what I wanted.
UWorld average: 87% first pass
NBME 16 (taken 1 week from exam): 255
NBME 18 (taken Wednesday): 257
NBME free 120: 93% (took right after NBME 18 to simulate a full test day)
UWSA 2 (taken yesterday): 266
But I've walked out of it feeling like I barely scraped 220. I don't think I've ever felt this disappointed in myself. I second guessed myself a lot of times, and changed answers that turned out to be right the first time. I've counted like ~8-10 questions already that I know I got wrong. I'm trying to resist thinking of more and looking them up, too. And the worst thing is I don't get my score for 2 months, so there's nothing to do but mope around for a few days and then start preparing for third year.
Anyway. Just wanted to get that off my chest/give some more insight into this horrible process that is Step 1.
